Ganglioside Antibodies in Children with Guillain-Barré Syndrome: A Narrative Review
Abstract
Guillain-Barré syndrome (GBS) is an acute immune-mediated polyradiculoneuropathy of the peripheral nervous system and one of the leading causes of acute flaccid paralysis in children. Although pediatric GBS often has a more favorable prognosis than adult disease, severe cases may cause respiratory failure, autonomic instability, prolonged disability, and rarely death. Antiganglioside antibodies are increasingly recognized as important contributors to GBS immunopathogenesis, clinical heterogeneity, diagnostic classification, and prognosis. These antibodies are commonly generated after antecedent gastrointestinal or respiratory infections through molecular mimicry and may target gangliosides expressed on peripheral nerves. In children, antiganglioside antibodies have been associated with acute motor axonal neuropathy, Miller Fisher syndrome, Bickerstaff brainstem encephalitis, and the pharyngeal-cervical-brachial variant. This narrative review summarizes the role of antiganglioside antibodies in pediatric GBS, focusing on immunopathogenesis, clinical associations, diagnostic value, therapeutic implications, limitations, and future research priorities. Although antibody testing can support diagnosis and subtype classification, interpretation remains limited by assay variability, incomplete sensitivity, and insufficient pediatric prognostic validation. Further pediatric-focused studies are needed to standardize testing, clarify prognostic significance, and support development of targeted therapies.
References
Elendu C, Osamuyi EI, Afolayan IA, Opara NC, Chinedu-Anunaso NA, Okoro CB, et al. Clinical presentation and symptomatology of Guillain-Barré syndrome: A literature review. Medicine 2024;103(30):e38890.
Malek E, Salameh J. Guillain–Barré syndrome. Semin Neurol 2019;39(5):589–95.
Jasti AK, Selmi C, Sarmiento-Monroy JC, Vega DA, Anaya JM, Gershwin ME. Guillain-Barré syndrome: causes, immunopathogenic mechanisms and treatment. Expert Rev Clin Immunol 2016;12(11):1175–89.
Shahrizaila N, Lehmann HC, Kuwabara S. Guillain–Barré syndrome. Lancet 2021;397(10280):1214–28.
Wachira VK, Farinasso CM, Silva RB, Peixoto HM, de Oliveira MR. Incidence of Guillain-Barré syndrome worldwide between 1985 and 2020: A systematic review. Glob Epidemiol 2023;5:100098.
Korinthenberg R, Trollmann R, Felderhoff-Müser U, Bernert G, Hackenberg A, Hufnagel M, et al. Diagnosis and treatment of Guillain-Barré syndrome in childhood and adolescence: guideline. Eur J Paediatr Neurol 2020;25:5–16.
Chevret S, Hughes RA, Annane D. Plasma exchange for Guillain-Barré syndrome. Cochrane Database Syst Rev 2017;2.
Bhagwat AP, Sharath HV, Warghat PA. Effect of pediatric rehabilitation in children with Guillain-Barré syndrome: Case series. Cureus 2024;16(5).
Khalifa M, Zakaria F, Ragab Y, Saad A, Bamaga A, Emad Y, et al. Guillain-Barré syndrome associated with SARS-CoV-2 infection in a child. J Pediatric Infect Dis Soc 2020;9(4):510–13.
Kusunoki S, Willison HJ, Jacobs BC. Antiglycolipid antibodies in Guillain-Barré and Fisher syndromes. J Neurol Neurosurg Psychiatry 2021;92(3):311–18.
Rajabally YA. Immunoglobulin and monoclonal antibody therapies in Guillain-Barré syndrome. Neurotherapeutics 2022;19(3):885–96.
Finsterer J. Triggers of Guillain–Barré syndrome: Campylobacter jejuni predominates. Int J Mol Sci 2022;23(22):14222.
Sipione S, Monyror J, Galleguillos D, Steinberg N, Kadam V. Gangliosides in brain physiology and disease. Front Neurosci 2020;14:572965.
Cutillo G, Saariaho AH, Meri S. Physiology of gangliosides and antiganglioside antibodies. Cell Mol Immunol 2020;17(4):313–22.
Xu Y, Zhao W, Shan J, Zhang Y, Gong Y, Wang L, et al. Role and mechanism of autoantibodies in dysimmunity neurological diseases. J Exp Neurol 2024;5(3):107–20.
Zhu W, Li K, Cui T, Yan Y. Detection of anti-ganglioside antibodies in Guillain–Barré syndrome. Ann Transl Med 2023;11(7).
Chiu AT, Chan RW, Yau ML, Yuen AC, Lam AK, Lau SW, et al. Guillain–Barré syndrome in children: high occurrence of Miller Fisher syndrome in East Asia. Brain Dev 2022;44(10):715–24.
Larrosa C, Mora J, Cheung NK. Global impact of anti-GD2 monoclonal antibodies in children. Cancers 2023;15(14):3729.
Gunasekara SK, Wickramasinghe C. Pharyngeal–cervical–brachial variant of Guillain–Barré syndrome. Sri Lanka J Med 2019;28(2).
Uysalol M, Tatlı B, Uzel N, Çıtak A, Aygün E, Kayaoğlu S. A rare pediatric PCB variant with anti-GD1a and anti-GD1b positivity. Balkan Med J 2013;2013(3):337–41.
Pradhan RR, Yadav SK, Yadav Sr SK. Pharyngeal–cervical–brachial variant of Guillain–Barré syndrome in children. Cureus 2020;12(2).
Hagen KM, Ousman SS. Neuroimmunology of Guillain–Barré syndrome and aging immune system. Front Aging Neurosci 2021;12:613628.
Shahrizaila N, Yuki N. Guillain–Barré syndrome, Fisher syndrome and Bickerstaff encephalitis pathogenesis. Neurol Asia 2010;15(3).
Odaka M, Yuki N, Yamada M, Koga M, Takemi T, Hirata K, et al. Bickerstaff brainstem encephalitis: Clinical features of 62 cases. Brain 2003;126(10):2279–90.
Ding Y, Yu L, Zhou S, Zhang L. Clinical features of seven children with Bickerstaff brainstem encephalitis in China. Front Neurol 2020;11:557.
Reyneveld GI, Savelkoul HF, Parmentier HK. Natural antibodies and modulation possibilities. Front Immunol 2020;11:2139.
Stino AM, Reynolds EL, Watanabe M, Callaghan BC. Prescribing patterns of IVIG and plasma exchange for GBS in the US (2001–2018). Muscle Nerve 2024.
Michel-Chávez A, Chiquete E, Gulías-Herrero A, Carrillo-Pérez DL, Olivas-Martínez A, Macías-Gallardo J, et al. Predictors of mechanical ventilation in axonal GBS subtypes. Can J Neurol Sci 2023;50(2):221–27.
Ripellino P, Schreiner B, Latorre D. Recent advances in understanding Guillain–Barré syndrome. Eur J Immunol 2024;2250336.
Magy L, Frachet S. Therapeutic issues in Guillain–Barré syndrome. Expert Rev Neurother 2023;23(6):549–57.
Papri N, Islam Z, Leonhard SE, Mohammad QD, Endtz HP, Jacobs BC. Guillain–Barré syndrome in low- and middle-income countries. Nat Rev Neurol 2021;17(5):285–96.
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